For many DS gamers, Trauma Center is representative of hardcore gaming on the DS as well as innovation characterized by both the series and the system. The series has expanded from the hardcore niche status it enjoyed with the original (Under the Knife), as both Wii titles are fairly popular now. With Trauma Center: Under the Knife 2, the franchise returns to its original system and ultimately provides a game experience that is the best in the series.

Plot-wise, Under the Knife 2 is just more of the same that we've come to expect from Trauma Center. Killer virus? Check. Shadowy organization? Also check. Medical hero willing to save the world from said killer virus? Yep, we've got that too, as Derek Stiles again takes front and center in an attempt to save lives from a medical catastrophe that is the aftermath of GUILT. Storytelling is better than in the original Trauma Center, and for such a gameplay-oriented title there's a lot of story in this game. The game deals with some surprisingly deep themes, and thanks to the great writing you'll grow attached to various characters as you progress through the story. You'll almost surely enjoy the storyline more if you've played the original Under the Knife, but it's not at all a requirement.

While a lot of basic gameplay implementations have stuck around since the original Trauma Center, Under the Knife 2 doesn't feel stale or overdone at all. It's the same gameplay fans have come to know and love, but with enough minor tweaks to ensure this doesn't feel like a simple rehash. All Dr. Stiles' basic tools are intact, such as the scalpel, forceps, drain, and laser, among others. The defibrillator is also available, which is a new tool for the DS Trauma Center titles.

What's really great about Under the Knife 2 is the developers really did obtain that sweet spot of introducing new players to the game but at the same time making sure things don't get boring for Trauma Center vets. The first few missions will recap certain procedures and the game is really great at teaching you what you'll need to do. After that, however, you're expected to remember how to deal with certain problems and you're left to fend for yourself with little help from the game. Under the Knife 2 can be really tough, but the learning curve is gradual enough that casual gamers don't need to be afraid of playing this game.

The core gameplay is essentially the same as that of the original Trauma Center, but it's still a lot of fun. Each operation includes some story, then some info on the patient and the required procedures, and then you're off to the O.R. The nurse helping you out will occasionally give you advice and generally points you in the right direction. It's then up to you, playing as Dr. Stiles, to use a handful of tools to save the patient's life. There's a time limit and operations don't always go as planned. As you work through the operation at a generally frantic pace, sudden problems may crop up that you'll have to deal with. Part of the fun is figuring out just what to do when faced with certain medical conditions, from excising tumors and removing aneurisms to facing some really extraordinary medical "monsters". Overall, gameplay is a lot of fun and will satisfy fans of the series as well as those wanting to hop on the Trauma Center bandwagon.